Objective To investigate the protective effect of β-glucan(BG)against intestinal ischemia reperfusion(II/R)injury by regulating the secretion of glucagon-like peptide-1(GLP-1).Methods Male C57BL/6 mice(6～8 weeks old)were subjected,and finally,the experiments had sham group,II/R group,II/R+BG group(0.1 mg/mL BG in drinking water for 2 weeks before modeling),II/R+liraglutide(LLT,GLP-1 analogue)group(0.2 μg/g LLT injected every 12 hours for 3 consecutive days before modeling),and II/R+BG+Ex9-39(GLP-1 R antagonist)group(intraperitoneal injection of 2 μg/g Ex9-39 1 h before modeling).After modeling,HE staining was used to observe intestinal morphological changes,and RT-qPCR and Western blotting were employed to evaluate the molecules(Occludin,ZO-1 and Claudin-1)related to intestinal barrier damage.The effect of 0.1 mg/mL BG treatment on the GLP-1 level in the serum and intestinal tissues of normal mice was determined with ELISA and immunofluorescence assay,respectively,and RT-PCR for the molecules related to GLP-1 expression(Gcg,Pcsk1/2,GIP and Foxa2).The effects of LLT and Ex9-39 pretreatment on intestinal morphology and intestinal barrier damage were also determined by morphological observation and expression levels of related molecules.Results II/R induced significant decreases in the mRNA levels of Occludin,ZO-1 and Claudin-1 and increase in Chiu's score when compared with sham control mice(P＜0.05).While,the mRNA levels of the 3 molecules were obviously higher and the Chiu's score was lower in the II/R+BG group than the II/R group(P＜0.05).BG pretreatment induced notably enhanced secretion of GLP-1 in the serum and intestinal tract of normal mice,and improved the mRNA expression of GLP-1-related molecules(P＜0.05).The intervention of GLP-1 analogue LLT could attenuate the II/R damage and decreased Chiu's score,with statistical difference in comparison with the II/R group(P＜0.05).GLP-1 receptor antagonist Ex9-39 reversed the protective effects of BG pretreatment against II/R damage,with notably differences in the expression of Occludin,ZO-1 and Claudin-1 and Chiu's score(P＜0.05).Conclusion BG can attenuate intestinal mucosal and functional injury after II/R by promoting intestinal GLP-1 secretion.

Objective To analyze the diversity and composition changes of gut fungal communities between patients with chronic kidney disease(CKD)and healthy controls.Methods A total of 8 CKD patients admitted in Department of Nephrology of our hospital,and another 5 age-and gender-matched healthy individuals were recruited in this study.Fresh fecal samples were collected from the CKD patients and healthy controls.ITS DNA sequencing was employed to determine the composition of intestinal fungi,and then bioinformatics analysis was applied to compare the differences in fungal community diversity,structure,and function between the 2 groups.Results There were no statistical differences between the 2 groups in terms of age,gender composition,BMI,and so forth.The results of Alpha diversity assessment showed statistical differences were observed in Simpson index and Shannon index in the intestinal fungi between the 2 groups(P＜0.01).So was in the Beta diversity between them(P＜0.01).The relative abundance of Candida was increased significantly(P＜0.01),while those of Cladosporium and Penicillium were decreased in the CKD group(P＜0.05).LEfSe analysis revealed that Candida was significantly enriched in CKD patients,whereas Cladosporium and Penicillium were significantly lower in abundance when compared to the healthy control group.Conclusion The composition of intestinal fungi in CKD patients is different from that in healthy individuals,exhibiting characteristic changes.Dysfunction of gut fungal flora may promote the progression of CKD.Regulating gut fungi and restoring gut microbiota homeostasis may become a new strategy for CKD treatment.

OBJECTIVE: Xuebijing injection has been recommended as a therapeutic approach for individuals with severe and critical COVID-19. This study aims to explore the correlation of neutrophil to lymphocyte platelet ratio (NLPR) with the severity and prognosis of COVID-19, and the effect of XBJ on the prognosis of patients with COVID-19 in different inflammatory states. METHODS: This was a retrospective study conducted at Wuhan Union Hospital in China. COVID-19 patients admitted between November 1, 2022 and February 1, 2023 were included. In predicting prognosis for individuals with COVID-19, new inflammatory indicators were used, and their prognostic value was assessed by using Cox regression models and receiver operating characteristic curves. Furthermore, a calculation was made to determine the cutoff value for NLPR. Relative risk and Cox regression models were used to examine the effects of Xuebijing injection on prognosis in patient cohorts that had been stratified by the NLPR cutoff. RESULTS: This research included 455 participants with COVID-19, with a mean age of 72 years. Several inflammatory indicators were found to be strongly correlated with prognosis, and NLPR shows the greatest predictive power. Patients with NLPR > 3.29 exhibited a mortality rate of 17.3%, which was 6.2 times higher than in patients with NLPR ≤ 3.29. Importantly, providing Xuebijing injection to patients with NLPR > 3.29 was associated with a lower risk of 60-day all-cause mortality. However, there was no discernible improvement in survival among patients with NLPR ≤ 3.29 who received Xuebijing injection. CONCLUSION NLPR is the most reliable inflammatory marker for predicting prognosis among individuals with COVID-19, and can accurately identify individuals who may benefit from Xuebijing injection. Please cite this article as: Liao M, Zhang LT, Bai LJ, Wang RY, Liu Y, Han J, Liu LH, Qi BL. Xuebijing injection reduces COVID-19 patients mortality as influenced by the neutrophil to lymphocyte platelet ratio. J Integr Med. 2025; 23(3): 282-288.
Humans ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Female ; Retrospective Studies ; Aged ; Neutrophils ; COVID-19 Drug Treatment ; COVID-19/blood* ; Middle Aged ; Prognosis ; Lymphocytes ; Blood Platelets ; Platelet Count ; SARS-CoV-2 ; Aged, 80 and over ; Adult

Objective:To analyze the association between osteoporosis and the risk for Alzheimer's disease (AD).Methods:A total of 471 922 study subjects were selected from the UK Biobank database, including 12 818 osteoporosis cases and 459 104 controls. Cox proportional hazard regression model and competing risk model were used to evaluate the association between osteoporosis and AD after adjusting confounding factors. Furthermore, a Mendelian randomization (MR) study was conducted by using the data of two published genome-wide association studies, and 1 050 highly relevant single nucleotide polymorphisms were identified from the bone mineral density data as instrumental variables. The association between bone mineral density and the risk for AD was evaluated by using inverse variance weighted method, MR-Egger regression, and weighted median estimator method. Additionally, sensitivity analyses were performed.Results:After adjusting for confounders, no significant association between osteoporosis and an increased risk for AD was found in the cohort study (Cox proportional hazard regression model analysis: HR=1.10, 95% CI: 0.78-1.56, P=0.588). The MR analysis revealed no association between bone mineral density and the risk for AD (inverse-variance weighted: OR=1.03, 95% CI: 0.98-1.09, P=0.252), and the results remained robust in multiple sensitivity analyses. Conclusion:The study result does not support the association between osteoporosis and risk for AD.

OBJECTIVE T o investigate the pathogenic bacteria causing postoperative infection in patients with diabe-tes undergoing orthopedic surgery and analyze the risk factors for such postoperative infections.METHODS A total of 140 patients with diabetes who underwent orthopedic surgery at the Second Affiliated Hospital of Guangxi Med-ical University from Jan.2023 to Dec.2024 were selected.Based on postoperative infection status,they were di-vided into an infection group(n=24)and a non-infection group(n=116).The two groups were compared in terms of gender,age,body mass index,blood glucose levels,operation time,surgical approach,incision length and other indicators.Logistic regression analysis was performed to explore the risk factors for postoperative infec-tion in patients with diabetes undergoing orthopedic surgery.Additionally,the infected strains and levels of in-flammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)]were measured.RESULTS Among the 140 patients,24 cases developed postoperative infections,with an incidence rate of 17.14％(24/140).The majority of infections occurred at the incision site(45.83％).The levels of IL-6,TNF-α and CRP in the infection group were(2.71±0.43)ng/ml,(9.71±1.58)ng/ml and(11.62±1.35)mg/L,respectively,significantly higher than those in the non-infection group(P＜0.05).HbA1c level(OR=5.987)and incision type(OR=9.356)were identified as risk factors for postoperative infection in patients with diabetes undergoing orthopedic surgery(P＜0.05).A total of 31 pathogenic bacteria were isolated from specimens of infec-ted patients,including 21 gram-positive bacteria(67.74％)and 9 gram-negative bacteria(29.03％),with Staphy-lococcus aureus and Staphylococcus epidermidis being the main pathogenic bacteria.CONCLUSIONS The postop-erative infection rate is high among patients with diabetes undergoing orthopedic surgery.Risk factors include HbA1c level and incision type,with Staphylococcus aureus and Staphylococcus epidermidis being the main path-ogenic bacteria.

Objectives:To evaluate the feasibility and clinical efficacy of eccentric occluder for the treatment of ventricular septal defect(VSD)without distance from the aortic valve.Methods:This analysis included 16 patients(9 males and 7 females)with VSD without distance from the aortic valve,who were treated at Fuwai Central China Cardiovascular Hospital from February 2022 to June 2024.Ten cases had mild right coronary sinus prolapse,and 2 had mild aortic valve regurgitation.All patients were diagnosed with VSD located zero-distance from aortic valve through transthoracic echocardiography(TTE)and left ventricular angiography.Eccentric occluder was used for interventional closure.TTE and 12-lead electrocardiography(ECG)were performed at 1 month,3 months,and 6 months after surgery to observe the presence of residual shunt,aortic valve regurgitation,and cardiac electrical conduction abnormalities.Results:Transcatheter closure was successful in 15 patients,procedure failed in one patient due to the unstable fixation of the occluder.Average diameter of the defect is(4.37±1.53)mm,and the diameter of the occluder is 6.5(6.0,8.0)mm.Postoperative left ventricular angiography showed minimal residual shunt in 3 cases,and no complications such as pericardial tamponade,hemolysis,thromboembolism,or infection,were observed.At one month after occlusion,TTE results showed that residual shunt disappeared in 3 patients with residual shunt.During 3-month and 6-month follow-up,all the occluders were well-positioned with no new aortic valve regurgitation or worsening of the original regurgitation,and no atrioventricular block or bundle branch block and other electrocardiographic conduction abnormalities.Conclusions:The use of eccentric occluder for intervention of ventricular septal defect patients without distance from the aortic valve is safe and effective.

Objective:To analyze the association between osteoporosis and the risk for Alzheimer's disease (AD).Methods:A total of 471 922 study subjects were selected from the UK Biobank database, including 12 818 osteoporosis cases and 459 104 controls. Cox proportional hazard regression model and competing risk model were used to evaluate the association between osteoporosis and AD after adjusting confounding factors. Furthermore, a Mendelian randomization (MR) study was conducted by using the data of two published genome-wide association studies, and 1 050 highly relevant single nucleotide polymorphisms were identified from the bone mineral density data as instrumental variables. The association between bone mineral density and the risk for AD was evaluated by using inverse variance weighted method, MR-Egger regression, and weighted median estimator method. Additionally, sensitivity analyses were performed.Results:After adjusting for confounders, no significant association between osteoporosis and an increased risk for AD was found in the cohort study (Cox proportional hazard regression model analysis: HR=1.10, 95% CI: 0.78-1.56, P=0.588). The MR analysis revealed no association between bone mineral density and the risk for AD (inverse-variance weighted: OR=1.03, 95% CI: 0.98-1.09, P=0.252), and the results remained robust in multiple sensitivity analyses. Conclusion:The study result does not support the association between osteoporosis and risk for AD.

Objectives:To analyze the clinical application effect of the preloaded snare technique in patients with risk of atrial septal occluder migration during percutaneous atrial septal defect(ASD)occlusion.Methods:The clinical data of 24 patients with secundum ASD who underwent preloaded snare-assisted transcatheter closure in Fuwai Central China Cardiovascular Hospital between December 2022 and August 2024 were retrospectively analyzed.The preprocedural echocardiography revealed that all patients presented with large secundum ASD or insufficient margins,indicating potential risk of device migration during percutaneous ASD occlusion.Consequently,preloaded snare technique was applied for ASD closure.Postprocedural evaluations were conducted to assess device stability(migration or shedding),residual shunt,pericardial effusion,and new-onset arrhythmia during the procedure,immediately after intervention,and at 1-month follow-up.Results:Among 24 patients,there were 4 males,with an average age of(37.88±13.18)years and an average weight of(59.70±10.78)kg.Twenty-two cases underwent successful interventional closure.Two cases occurred atrial septal occluder migration during the procedure,both were successfully retrieved using the preloaded snare and subsequently scheduled for surgical repair.Postprocedural electrocardiograms and echocardiograms(obtained immediately and at 1-month follow-up)demonstrated no device migration,residual shunt,occluder dislodgement,pericardial effusion,or new-onset arrhythmias.Conclusions:The preloaded snare technique can reduce the risk of atrial septal occluder migration and shedding,simplify the process of retrieving the occluder,enhance the safety of the intervention,and avoid emergency surgical intervention in high-risk populations.

Objectives:To evaluate the feasibility and clinical efficacy of eccentric occluder for the treatment of ventricular septal defect(VSD)without distance from the aortic valve.Methods:This analysis included 16 patients(9 males and 7 females)with VSD without distance from the aortic valve,who were treated at Fuwai Central China Cardiovascular Hospital from February 2022 to June 2024.Ten cases had mild right coronary sinus prolapse,and 2 had mild aortic valve regurgitation.All patients were diagnosed with VSD located zero-distance from aortic valve through transthoracic echocardiography(TTE)and left ventricular angiography.Eccentric occluder was used for interventional closure.TTE and 12-lead electrocardiography(ECG)were performed at 1 month,3 months,and 6 months after surgery to observe the presence of residual shunt,aortic valve regurgitation,and cardiac electrical conduction abnormalities.Results:Transcatheter closure was successful in 15 patients,procedure failed in one patient due to the unstable fixation of the occluder.Average diameter of the defect is(4.37±1.53)mm,and the diameter of the occluder is 6.5(6.0,8.0)mm.Postoperative left ventricular angiography showed minimal residual shunt in 3 cases,and no complications such as pericardial tamponade,hemolysis,thromboembolism,or infection,were observed.At one month after occlusion,TTE results showed that residual shunt disappeared in 3 patients with residual shunt.During 3-month and 6-month follow-up,all the occluders were well-positioned with no new aortic valve regurgitation or worsening of the original regurgitation,and no atrioventricular block or bundle branch block and other electrocardiographic conduction abnormalities.Conclusions:The use of eccentric occluder for intervention of ventricular septal defect patients without distance from the aortic valve is safe and effective.

OBJECTIVE T o investigate the pathogenic bacteria causing postoperative infection in patients with diabe-tes undergoing orthopedic surgery and analyze the risk factors for such postoperative infections.METHODS A total of 140 patients with diabetes who underwent orthopedic surgery at the Second Affiliated Hospital of Guangxi Med-ical University from Jan.2023 to Dec.2024 were selected.Based on postoperative infection status,they were di-vided into an infection group(n=24)and a non-infection group(n=116).The two groups were compared in terms of gender,age,body mass index,blood glucose levels,operation time,surgical approach,incision length and other indicators.Logistic regression analysis was performed to explore the risk factors for postoperative infec-tion in patients with diabetes undergoing orthopedic surgery.Additionally,the infected strains and levels of in-flammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)]were measured.RESULTS Among the 140 patients,24 cases developed postoperative infections,with an incidence rate of 17.14％(24/140).The majority of infections occurred at the incision site(45.83％).The levels of IL-6,TNF-α and CRP in the infection group were(2.71±0.43)ng/ml,(9.71±1.58)ng/ml and(11.62±1.35)mg/L,respectively,significantly higher than those in the non-infection group(P＜0.05).HbA1c level(OR=5.987)and incision type(OR=9.356)were identified as risk factors for postoperative infection in patients with diabetes undergoing orthopedic surgery(P＜0.05).A total of 31 pathogenic bacteria were isolated from specimens of infec-ted patients,including 21 gram-positive bacteria(67.74％)and 9 gram-negative bacteria(29.03％),with Staphy-lococcus aureus and Staphylococcus epidermidis being the main pathogenic bacteria.CONCLUSIONS The postop-erative infection rate is high among patients with diabetes undergoing orthopedic surgery.Risk factors include HbA1c level and incision type,with Staphylococcus aureus and Staphylococcus epidermidis being the main path-ogenic bacteria.